Announcements of Death During the COVID-19 Pandemic: A Qualitative Study of Family Experiences.

Introduction: Health restrictions resulting from COVID-19 made it more difficult for families to mourn. The death announcement is a significant moment for families. The aim of this study was to explore the experiences, perceptions and expectations of families who were informed of the death of a close relative in the hospital, at home or in a care home for dependent elderly people (EHPAD) during the COVID-19 pandemic.

Methods: This qualitative study was based on interpretative phenomenology and involved individual semidirected interviews with families of patients who died in 2020 in the Auvergne region, in hospitals, at home and in establishments for dependent elderly people, with double analysis.

Results: Three themes emerged from the 17 interviews. Families' experiences of the announcement of the death of a loved one were complex due to the pandemic as well as the corresponding health restrictions and new forms of communication, thus leading to fear, helplessness, frustration, sadness, anger, guilt and loneliness. High-quality communication with caregivers, both at the announcement of death and beforehand, was essential. The families highlighted various areas for improvement: family visits with the patient, effective telecommunication, close emotional support after the announcement, reflection by caregivers on their own defence mechanisms in response to death, and a care system that revalues 'taking care'.

Conclusions: Families' experiences with receiving news regarding the death of a close relative during the pandemic depended on the quality of their communication with caregivers, which could mitigate the traumatic impacts of health measures and relational deprivation. Adjustments are necessary in the event of similar pandemic situations.

Patient Or Public Contribution: The conception of our study was based on discussions with families in hospitals or general practice who reported their difficulties and suffering at the time of the death of a close relative during the COVID-19 pandemic. We reasoned that understanding the experiences of people who had experienced the death of a loved one in this health context would enable us to determine whether relationships with caregivers met their expectations or whether they needed to be adapted. To place the experience of families at the centre of this research, a participatory research method with a qualitative approach was used. The families of patients who died in 2020 in the Auvergne region during the COVID-19 pandemic were included in the study. A list of families has been established from the healthcare software of a hospital, a home for dependent elderly people and two multiprofessional primary care practices. Twenty-six relatives of patients were contacted, and 17 interviews were conducted. Seven people refused to participate, one person did not participate in the follow-up, and one person could not be contacted. Based on discussions with relatives of deceased patients and a literature search, we established an interview guide. The families approached volunteered to share their experiences and subsequently validated the study data.